WO2023181296A1 - Surgery assistance device - Google Patents
Surgery assistance device Download PDFInfo
- Publication number
- WO2023181296A1 WO2023181296A1 PCT/JP2022/014134 JP2022014134W WO2023181296A1 WO 2023181296 A1 WO2023181296 A1 WO 2023181296A1 JP 2022014134 W JP2022014134 W JP 2022014134W WO 2023181296 A1 WO2023181296 A1 WO 2023181296A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- clamper
- base
- fixed
- support device
- surgical
- Prior art date
Links
- 238000001356 surgical procedure Methods 0.000 title description 14
- 238000003780 insertion Methods 0.000 description 39
- 230000037431 insertion Effects 0.000 description 39
- 238000006073 displacement reaction Methods 0.000 description 10
- NJPPVKZQTLUDBO-UHFFFAOYSA-N novaluron Chemical compound C1=C(Cl)C(OC(F)(F)C(OC(F)(F)F)F)=CC=C1NC(=O)NC(=O)C1=C(F)C=CC=C1F NJPPVKZQTLUDBO-UHFFFAOYSA-N 0.000 description 6
- 230000007246 mechanism Effects 0.000 description 5
- 230000001105 regulatory effect Effects 0.000 description 5
- 238000000034 method Methods 0.000 description 4
- 230000037237 body shape Effects 0.000 description 3
- 238000013459 approach Methods 0.000 description 2
- 210000003815 abdominal wall Anatomy 0.000 description 1
- 238000005286 illumination Methods 0.000 description 1
- 238000003384 imaging method Methods 0.000 description 1
- 239000004615 ingredient Substances 0.000 description 1
- 230000002093 peripheral effect Effects 0.000 description 1
- 230000029058 respiratory gaseous exchange Effects 0.000 description 1
- 230000001954 sterilising effect Effects 0.000 description 1
- 238000004659 sterilization and disinfection Methods 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
- A61B34/37—Master-slave robots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/50—Supports for surgical instruments, e.g. articulated arms
Definitions
- the present invention relates to the technical field of a surgical support device having a fixed base that can be fixed to a surgical table.
- Such a surgical support device includes a plurality of connecting arms that are rotatably or rotatably connected in order. Some have a holder connected to them to hold the ingredients. As surgical tools, endoscopes, forceps, etc. are used depending on the type and situation of the surgery.
- a surgical support device when a plurality of connecting arms are pivoted or rotated in a predetermined direction, the position and posture of the surgical tool are changed in accordance with the movement of the connecting arms, and the surgical tool held in the holder performs a surgical operation. will be held.
- a surgical operation using the above-mentioned surgical support device is generally performed by an operator (doctor) remotely operating the surgical support device installed in the operating room using a master-slave method.
- a pivot point is set as a reference point for the position and posture of the surgical instrument.
- the pivot point is a position that approximately corresponds to a port formed in the patient's body cavity into which a surgical tool is inserted, and when a trocar is used, it approximately corresponds to the position of the trocar. Therefore, when a surgical instrument is inserted into a patient's body cavity, the position and posture of the surgical instrument are controlled so that a part of the surgical instrument always passes through the pivot point; This prevents the occurrence of a load on tissues near the patient's body surface, thereby ensuring safety.
- surgical support devices described above are used while being fixed to the operating table with a clamper during surgery (see, for example, Patent Document 1 and Patent Document 2). Further, such a surgical support device may be fixed to a stand (carriage) by a clamper and can be used with the stand installed around the operating table.
- JP2021-78781A Japanese Patent Application Publication No. 2002-191545
- each part of the surgical support device does not interfere with the operating table, and the stand is used as close to the operating table as possible, increasing usability. It is also desired that
- the surgical support device includes a plurality of connecting arms, a holder supported by the connecting arms, and a fixed base to which the connecting arms are connected, and the fixed base is a base in which predetermined parts are arranged. It has a main body and a clamper, at least a portion of which protrudes from the base main body and can be fixed to a surgical table, and the position of the clamper in the vertical direction with respect to the base main body can be changed.
- the position of the clamper in the vertical direction relative to the base body can be changed in either the state where it is fixed to the operating table or the state where it is fixed to the stand.
- the position of the clamper in the vertical direction with respect to the base body can be changed in both the state in which the fixed base is fixed to the operating table and the state in which it is fixed to the stand, so that the clamper is fixed to the operating table.
- the surgical support device can be set at the optimal height when the surgical support device is being used, and the clamper can be removed when it is fixed to the stand so that it does not interfere with the operating table, improving usability in any situation. can be achieved.
- FIG. 2 is a perspective view showing a state in which the surgical support device is installed on a stand.
- FIG. 3 is a sectional view showing a state before the clamper is fixed to the base body. It is a perspective view of a clamper.
- FIG. 6 is a perspective view of the clamper as seen from a different direction from FIG. 5;
- FIG. 3 is a cross-sectional view showing a state in which the clamper is being fixed to the base body.
- FIG. 3 is a sectional view showing a state in which the clamper is fixed to the base body.
- FIG. 2 is an exploded perspective view showing a separator and an adapter to which a surgical tool is attached.
- An operating table 100 is installed in the operating room, and a patient 200 is lying on the operating table 100, for example, in a supine state.
- a fixing rail 100a is provided on the side of the operating table 100.
- a port 202 is formed in the body cavity 201 of the patient 200, for example, the abdominal wall 201a. A portion of a surgical tool, which will be described later, is inserted into the port 202 when a surgical operation is performed.
- Port 202 is a small hole into which a portion of a surgical tool is inserted.
- the surgical support device 1 has a device main body 2 and a holder 3. Inside the device main body 2, for example, one electric motor (not shown) and a plurality of pneumatic actuators (not shown) are arranged.
- the device main body 2 has a fixed base 4 that can be fixed to the operating table 100 and an arm body 5 connected to the fixed base 4.
- the fixed base 4 includes a substantially rectangular parallelepiped-shaped base body 6 in which various predetermined mechanisms are provided, a pedestal 7 rotatably supported by the base body 6, and a clamper whose parts except a part protrude from the base body 6. 8.
- the fixed base 4 is rotatably supported by a pedestal 7 about an axis S1 extending perpendicularly to the base body 6 as a fulcrum.
- the pedestal 7 is rotated relative to the fixed base 4 by, for example, the driving force of an electric motor.
- the arm body 5 has a first connecting arm 9, a second connecting arm 10, and a third connecting arm 11. Note that the number of connecting arms in the arm body 5 is not limited to three, and may be a plurality of connecting arms, and may be two or four or more.
- the first connecting arm 9 has a first connecting portion 9a connected to the pedestal 7, and is rotatable relative to the pedestal 7 about a horizontally extending axis S2 as a fulcrum.
- the first connecting arm 9 is rotated relative to the base 7 by, for example, a pneumatic actuator operated by compressed air supplied from a compressor.
- the second connection arm 10 has one end in the longitudinal direction provided as a first connection part 10a, and the other end in the longitudinal direction provided as a second connection part 10b.
- the second connecting arm 10 has a first connecting part 10a connected to a second connecting part 9b of the first connecting arm 9, and rotates with respect to the first connecting arm 9 about an axis S3 extending in the horizontal direction. be made movable.
- the second connecting arm 10 is rotated relative to the first connecting arm 9 by a pneumatic actuator operated by compressed air supplied from a compressor, for example.
- the third connecting arm 11 in the longitudinal direction is provided as a first connecting part 11a, and the other end in the longitudinal direction is provided as a second connecting part 11b.
- the second connecting portion 11b is composed of, for example, two arm portions.
- the first connecting part 11a is connected to the second connecting part 10b of the second connecting arm 10
- the second connecting arm 10 is connected to the axis S4 extending in a direction orthogonal to the axis S3 as a fulcrum.
- the third connecting arm 11 is not rotated by an external driving force such as the driving force of an electric motor or a pneumatic actuator, and is not rotated by its own weight or other forces such as the first connecting arm 9 or the second connecting arm 10. This is a part that rotates freely according to the movement.
- the holder 3 is rotatably supported (connected) to the second connecting portion 11b of the third connecting arm 11.
- the holder 3 is rotatable relative to the third connecting arm 11 about an axis S5 extending in a direction perpendicular to the axis S4.
- the holder 3 is not rotated by an external driving force such as the driving force of an electric motor or a pneumatic actuator, but is rotated by its own weight, the first connecting arm 9, the second connecting arm 10, the third connecting arm 11, etc. It is a part that performs a free rotational movement that rotates in response to other movements.
- the holder 3 has a base cylinder part 12 which is partially rotatable and is not rotated, a rotating part 13 rotatably supported by the base cylinder part 12, and a connecting cylinder part 14 attached to the base cylinder part 12. (See Figure 3).
- a part of the rotating part 13 is located inside the base cylindrical part 12 and the connecting cylindrical part 14, and a rear end part is located on the rear side of the base cylindrical part 12.
- the rotating part 13 is rotatable relative to the base cylinder part 12 and the connecting cylinder part 14 in a direction around an axis S6 orthogonal to the axis S5.
- the rotating part 13 is rotatable by, for example, a pneumatic actuator operated by compressed air supplied from a compressor, and can also be rotated manually.
- a locking mechanism (not shown) is arranged inside the holder 3.
- a lock release button 14a is arranged on the connecting cylinder portion 14.
- a switching button 13a is arranged at the rear end of the rotating section 13. The switching button 13a has a function of switching the driving force for rotating the rotating section 13.
- each part is configured to be rotatable or rotatable about six axes from the axis S1 to the axis S6, so the orientation and position of the surgical tool held in the holder 3 It has a high degree of freedom (posture) and can perform surgery quickly and with high precision.
- a high degree of freedom posture
- the axes S4 and S5 are perpendicular to each other, when the direction or position of the surgical instrument inserted into the port 202 is changed or when the patient 200 When the direction or position of the port 202 is changed due to breathing conditions or the like, the load on tissues near the body surface of the patient 200 can be reduced.
- rotation of the arm body 5 on the axis S1 at the farthest position from the surgical tool is performed by the driving force of the electric motor, and the axis S2 and the axis S3 at a position closer to the surgical tool than the axis S1 are rotated.
- the rotation or rotation about the axis S6 is performed by the driving force of the pneumatic actuator.
- the arm body 5 is operated at a position close to the surgical instrument by the driving force of the pneumatic actuator, which has a smaller load on the patient 200 than the driving force of the electric motor, further reducing the load on the tissues near the body surface of the patient 200. be able to.
- the tissue near the body surface of the patient 200 is It is possible to reduce the load.
- an ultrasonic motor such as a piezoelectric motor capable of highly accurate positioning may be used instead of the electric motor or pneumatic actuator. By using the ultrasonic motor, it is possible to save power and downsize the surgical support device 1.
- the fixed base 4 includes the base body 6, the pedestal 7, and the clamper 8 (see FIGS. 2 and 3).
- the base main body 6 has an outer casing 15 formed in a substantially rectangular parallelepiped shape and various predetermined mechanisms arranged inside the outer casing 15. 18, a lower surface portion (not shown), and a rear surface portion (not shown) (see FIGS. 3 and 4).
- a plurality of positioning holes 16a are formed in the front part 16. For example, three positioning holes 16a are formed vertically apart from each other.
- a plurality of arrangement holes 16b are formed in the front part 16. The arrangement hole 16b is formed on the outer side and slightly below the positioning hole 16a in the left-right direction. Therefore, three placement holes 16b are formed on each side of the positioning hole 16a.
- the number of positioning holes 16a is arbitrary as long as it is plural, and one arrangement hole 16b is formed on each side of each positioning hole 16a.
- the base body 6 is provided with fixing protrusions 19 that protrude outward from a pair of side surfaces 18, respectively.
- the fixing protrusion 19 is provided at a position near the upper end of the side surface portion 18.
- the base body 6 is provided with a locking member 20 that is partially inserted into the placement hole 16b (see FIG. 4).
- the locking member 20 is formed into a cylindrical shape with its axial direction extending in the front-rear direction, and its front end is inserted into the arrangement hole 16b.
- a space inside the locking member 20 is formed as an insertion hole 21.
- An inclined surface whose diameter increases toward the rear is formed in the axially intermediate portion of the inner circumferential surface of the locking member 20, and this inclined surface serves as a locking engagement portion 20a.
- the insertion hole 21 is formed as a displacement regulating part 21a in which a portion on the front side of the locking engagement portion 20a has a smaller diameter than a portion on the rear side.
- An air suction pipe protrudes from the rear surface of the base body 6.
- the air suction pipe is connected to the compressor via a suction tube. Therefore, compressed air is supplied to the inside of the fixed base 4 from the compressor.
- the compressed air supplied to the inside of the fixed base 4 passes through the inside of the fixed base 4 to the inside of the arm body 5, and is driven to rotate or rotate the first connecting arm 9, the second connecting arm 10, and the holder 3. Used as a force.
- the clamper 8 has a clamp base 22, a lower clamp portion 23, a clamp lever 24, and a pair of locked members 25 (see FIGS. 4 to 6).
- the clamp base 22 includes a substantially rectangular frame portion 26 that is penetrated from front to back, an upper clamp portion 27 that protrudes forward from the upper end of the frame portion 26, and an upper clamp portion 27 that extends forward from both left and right sides of the frame portion 26, respectively.
- a screw hole (not shown) is formed in the upper clamp part 27 and extends vertically.
- An upper insertion recess 27a that is open downward and laterally is formed at a position near the front end of the upper clamp portion 27.
- the front end of the support plate part 28 is located rearward than the front end of the upper clamp part 27.
- the support plate portion 28 is provided with a stopper shaft 28a that projects inward in the left-right direction.
- a shaft insertion hole 30 is formed in the mounting protrusion 29, and the shaft insertion hole 30 consists of a large diameter portion 31 located on the front side and a small diameter portion 32 located on the rear side (FIG. 4). reference).
- the mounting protrusion 29 has an annular stepped surface 33 facing forward at the boundary between the large diameter portion 31 and the small diameter portion 32 .
- the clamper 8 is provided with a positioning pin 34 that projects rearward from the frame portion 26 (see FIG. 6).
- the lower clamp part 23 is rotatably supported by a pair of support plate parts 28 below the upper clamp part 27.
- the lower clamp portion 23 has a main body portion 35 located between a pair of support plate portions 28 and a pair of supported shaft portions 36 protruding outward from the main body portion 35 in the left-right direction.
- the main body portion 35 is formed in a flat shape and has a lower insertion recess 35a that is open upwardly and laterally at the front end.
- the rear end portion of the main body portion 35 is provided as a pressed portion 35b.
- the lower clamp portion 23 is rotatable with respect to the clamp base 22 with the supported shaft portion 36 as a fulcrum as the supported shaft portion 36 is supported by the pair of support plate portions 28 .
- the supported shaft portion 36 protrudes from a portion between the lower insertion recess 35a and the pressed portion 35b.
- a coil portion 37a of a torsion coil spring 37 is supported by the supported shaft portion 36.
- One arm portion 37b of the torsion coil spring 37 is engaged with the support plate portion 28, and the other arm portion 37c is engaged with the main body portion 35. Therefore, the lower clamp part 23 is biased by the biasing force of the torsion coil spring 37 in the direction in which the pressed part 35b approaches the upper clamp part 27.
- the rotation of the lower clamp portion 23 in the direction urged by the torsion coil spring 37 is restricted by the main body portion 35 coming into contact with the stopper shaft 28a of the support plate portion 28.
- the clamp lever 24 is composed of a rotational operation section 24a and a screw shaft section 24b, and the screw shaft section 24b projects downward from the rotation operation section 24a.
- a screw groove is formed on the outer peripheral surface of the screw shaft portion 24b.
- the clamp lever 24 is screwed into the screw hole with the screw shaft portion 24b passing through the upper clamp portion 27, and the lower end of the screw shaft portion 24b is in contact with the pressed portion 35b of the main body portion 35 from above. There is.
- the pressed portion 35b of the main body portion 35 is pressed against the lower end of the helical shaft portion 24b by the urging force of the torsion coil spring 37. Therefore, when the rotation operating portion 24a of the clamp lever 24 is manually rotated, the threaded groove threaded into the screw hole is sent in the axial direction of the threaded shaft portion 24b, and the threaded portion 24b is rotated by the rotation operating portion 24a.
- the lower clamp portion 23 is rotated with respect to the clamp base 22 using the supported shaft portion 36 as a fulcrum.
- the locked member 25 is formed into a shaft shape that extends back and forth (see FIG. 6).
- approximately half of the front side excluding the front end is provided as a first insertion section 38, and approximately half of the rear side thereof is provided as a second insertion section 39.
- the diameter of the first insertion portion 38 is larger than the diameter of the second insertion portion 39, and is one size smaller than the diameter of the large diameter portion 31 of the shaft insertion hole 30 formed in the mounting projection 29.
- the diameter of the second insertion portion 39 is one size smaller than the diameter of the small diameter portion 32 of the shaft insertion hole 30 formed in the mounting protrusion 29, and is approximately the same as the diameter of the displacement regulating portion 21a of the locking member 20. .
- a plurality of lock balls 40 are supported in a portion near the rear end of the second insertion portion 39 so as to be displaceable and spaced apart in the circumferential direction (see FIG. 4).
- the locking ball 40 is displaceable in the radial direction of the second insertion section 39, and is between a protruding position where it protrudes the most from the second insertion section 39 and a retracted position where it is most drawn into the inside of the second insertion section 39. Displaced.
- the locking ball 40 is biased in a direction from the retracted position toward the ejected position by a biasing spring (not shown) disposed inside the second insertion portion 39 .
- the clamper 8 is attached to the base body 6 in the following manner (see FIGS. 4, 7, and 8).
- the clamper 8 is positioned with respect to the base body 6 by inserting the positioning pin 34 into the positioning hole 16a of the base body 6. At this time, the positioning pin 34 is inserted into one of the positioning holes 16a formed vertically apart from each other, so that the clamper 8 can be attached to the base body 6 at a desired height.
- the shaft insertion hole 30 formed in the mounting protrusion 29 is aligned with the insertion hole 21 of the locking member 20 from the front to the rear (see FIG. 4).
- the pair of locked members 25 are sequentially inserted into the shaft insertion hole 30 formed in the mounting protrusion 29 and the insertion hole 21 of the locking member 20, respectively.
- the lock ball 40 in the protruding position moves into the displacement restriction part.
- the displacement toward the protruding position is regulated by 21a, and the displacement toward the retracted position is performed against the biasing force of the biasing spring (see FIG. 7).
- the displacement of the locking ball 40 is transmitted to the operator's fingers, and the operator can use the clamping force of the locking member 20 to 8 is recognized to have been completely locked to the base body 6. Further, when the lock ball 40 is engaged with the locking engagement portion 20a, a sound may be generated as the lock ball 40 is displaced. It is recognized that locking of the clamper 8 to the base body 6 by the clamper 20 is completed.
- the two lockable members 25 are provided on the clamper 8, and the two lockable members 25 are respectively engaged with the base body 6 to lock the clamper 8 to the base body 6.
- a member 20 is provided.
- the locking member 20 is formed in a cylindrical shape
- the locked member 25 is formed in a shaft shape
- the clamper 8 is locked to the base body 6 by inserting the locked member 25 into the locking member 20 to a predetermined position. Ru.
- the clamper 8 is locked to the base body 6 by inserting the locked member 25 into the locking member 20, so that the clamper 8 can be locked to the base body 6 easily and reliably.
- the member to be locked 25 is pulled out from the insertion hole 21 and the shaft insertion hole 30, the engagement of the locking ball 40 with the locking engagement portion 20a is released, and the positioning pin 34 is removed from the locking engagement portion 20a of the locking ball 40. This can be done by pulling it out from the positioning hole 16a.
- a threaded groove portion is formed in a part of the inner circumferential surface of the locking member 20 and a part of the outer circumferential surface of the locked member 25, and the threaded groove portions are screwed together. 25 may be rotated with respect to the locking member 20, and the locked member 25 may be moved in the axial direction with respect to the locking member 20.
- a separator 41 is removably attached to the holder 3.
- the separator 41 includes a substantially disk-shaped mounting portion 42, an insertion portion 43 protruding from one surface of the mounting portion 42 in the thickness direction, and a pair of engaging portions 44 protruding from the other surface of the mounting portion 42 in the thickness direction. It has The separator 41 is attached to the holder 3 with the insertion portion 43 inserted into the front end of the holder 3 and locked by the locking mechanism. The separator 41 can be unlocked from the holder 3 by operating the lock release button 14a of the holder 3.
- the adapter 45 is detachably attached to the separator 41.
- the adapter 45 is made up of, for example, a first member 46 and a second member 47 coupled at the top and bottom, and is provided as an attached part 48 whose rear end is engaged with and attached to the separator 41.
- a surgical tool 80 is attached to the adapter 45.
- the surgical tool 80 is provided, for example, as a scope unit having an endoscope, and includes a shaft portion 81 in which a plurality of lenses are arranged, a head portion 82 coupled to one end of the shaft portion 81, and an intermediate portion between the shaft portion 81. It has a light guide 83 coupled to the section.
- An image sensor (not shown) is arranged inside the head section 82 .
- Cables serving as signal lines and power lines are connected to the head portion 82, and a ride guide cable (not shown) for guiding light is connected to the light guide 83.
- the surgical tool 80 is held by the adapter 45 by having the head portion 82 sandwiched between the first member 46 and the second member 47 from above and below.
- the adapter 45 holding the surgical tool 80 is attached to the separator 41 by inserting the attachment portion 48 between the pair of engagement portions 44 and engaging the attachment portion 42 and the engagement portion 44 . Therefore, the surgical tool 80 is held in the holder 3 via the adapter 45 and separator 41.
- At least the distal end of the shaft portion 81 of the surgical tool 80 is inserted into the body cavity 201 through a port 202 formed in the patient 200.
- illumination light is emitted from the distal end of the shaft portion 81, and the state inside the body cavity 201 is photographed by the imaging device.
- the fixed base 4 is installed on a stand 50 that can also be used as a trolley, and is transported to a sterilization room by the stand 50, where it is sterilized, transported to an operating room, and used in a surgery. made possible.
- the stand 50 has a chassis 52 on which a plurality of wheels 51 are supported, a connection base 53 connected to the chassis 52, and a device fixing part 54 connected to the connection base 53.
- the connection base 53 and the device fixing part 54 are located above the vehicle chassis 52, and the position of the device fixing part 54 can be adjusted in the vertical direction with respect to the connection base 53. Therefore, in the stand 50, the height of the surgical support device 1 can be changed by adjusting the height of the device fixing portion 54.
- the upper part of the device fixing part 54 is bent rearward with respect to the lower part, and the rearward bent part is a handle part 54a that is grasped by the user (carrier).
- the device fixing portion 54 is provided with a pair of fixing arm portions 54b that protrude downward and forward from the handle portion 54a and are spaced apart from each other in the left and right directions.
- the fixing base 4 is fixed to the stand 50 by, for example, attaching fixing members 55 to a pair of fixing protrusions 19 that protrude outward from the side surface 18, and fastening the fixing members 55 to the fixing arm portions 54b. This is done by fastening with the tool 56.
- the clamper 8 When the fixed base 4 is fixed to the stand 50 and the surgical support device 1 is installed on the stand 50, the clamper 8 is positioned on the opposite side of the handle portion 54a with the base body 6 interposed therebetween.
- the surgical support device 1 can be used during surgery with the fixed base 4 fixed to the fixing rail 100a of the operating table 100 by the clamper 8 (see FIG. 1).
- the clamper 8 has the positioning hole 16a and the insertion hole 21 with different heights, so that the positioning pin 34 and the locked member 25 are inserted into either the positioning hole 16a or the insertion hole 21, respectively.
- the clamper 8 is attached to the base body 6 at an appropriate height and locked.
- the clamper 8 is fixed to the fixing rail 100a by rotating the clamp lever 24 in one direction while the fixing rail 100a is inserted between the upper clamp part 27 and the lower clamp part 23. be exposed.
- the clamp lever 24 is rotated, the lower clamp part 23 is rotated with respect to the clamp base 22 in a direction in which the lower insertion recess 35a approaches the upper clamp part 27 using the pair of supported shaft parts 36 as fulcrums. . Therefore, the fixing rail 100a is inserted between the upper insertion recess 27a of the upper clamp part 27 and the lower insertion recess 35a of the lower clamp part 23, and the fixing rail 100a is inserted between the upper clamp part 27 and the lower clamp part 23.
- the fixed base 4 is fixed to the fixing rail 100a by the clamper 8.
- the surgical support device 1 can be used even when the fixed base 4 is fixed to the stand 50 during surgery (see FIG. 3).
- the surgical support device 1 is used with the fixed base 4 fixed to the stand 50, it is desirable to use the surgical support device 1 as close to the operating table 100 as possible.
- the clamper 8 is removably attached to the base body 6, and the clamper 8 is not required when the surgical support device 1 is used with the fixed base 4 fixed to the stand 50. Therefore, in this case, it is possible to remove the clamper 8 from the base body 6 and use the surgical support device 1. Therefore, by removing the clamper 8 protruding from the base body 6, it is possible to move the surgical support device 1 and the stand 50 closer to the operating table 100.
- the surgical support device 1 can be used by attaching the clamper 8 to a position where it does not interfere with the operating table 100, for example, at the lowest position. It is also possible to remove the clamper 8 and use the surgical support device 1.
- the fixed base 4 includes a base main body 6 in which predetermined parts can be arranged, and a clamper 8 that at least partially protrudes from the base main body 6 and is fixed to the operating table 100. The position of the clamper 8 relative to the base body 6 in the vertical direction can be changed.
- the position of the clamper 8 in the vertical direction relative to the base body 6 can be changed in both the state in which the fixed base 4 is fixed to the operating table 100 and the state in which it is fixed to the stand 50.
- the surgical support device 1 can be set at an optimal height when the fixed base 4 is fixed to the operating table 100, and the clamper 8 can be removed to interfere with the operating table 100 when the fixed base 4 is fixed to the stand 50. This makes it possible to improve the usability of the surgical support device 1 in any situation.
- the clamper 8 may be made vertically movable relative to the base body 6 by driving a motor or the like.
- a rotary operation section having a ball screw or the like may be used, and the clamper 8 may be made vertically movable with respect to the base body 6 by manually rotating the rotation operation section.
- the clamper 8 is removably attached to the base body 6, when the base body 6 is fixed to the stand 50 with the clamper 8 removed from the base body 6 and the surgical support device 1 is used in a surgery, it is possible to perform a surgical operation. Since the clamper 8 does not interfere with the table 100, the surgical support device 1 can be used close to the surgical table 100, and the usability of the surgical support device 1 can be further improved.
- the height of the surgical support device 1 is adjusted by the height adjustment mechanism of the stand 50. It is possible to change the size depending on the body shape of the patient 200, the surgical method, etc.
- the mounting position of the clamper 8 with respect to the base body 6 may be changed. By adjusting the height of the surgical support device 1, it is possible to change the height of the surgical support device 1 depending on the body shape of the patient 200, the method of surgery, etc.
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Abstract
The present invention comprises: a plurality of connecting arms; a holder supported by the connecting arms; and a fixed base to which the connecting arms are connected. The fixed base has a base body in which prescribed parts are arranged, and a clamper at least a part of which protrudes from the base body and which can be fixed to an operating table. The position of the clamper in the up-down direction relative to the base body is changeable. Due to this configuration, the position of the clamper in the up-down direction relative to the base body can be changed, in a state where the fixed base is fixed to the operating table or fixed to a stand.
Description
本発明は、手術台に固定可能な固定ベースを有する手術支援装置についての技術分野に関する。
The present invention relates to the technical field of a surgical support device having a fixed base that can be fixed to a surgical table.
近年、手術支援装置を用いた外科手術が普及しつつある。このような手術支援装置は、順に回動可能又は回転可能に連結された複数の連結アームを備え、連結アームがアクチュエーター等の駆動力によって動作され、連結方向における一端に位置された連結アームに手術具を保持するためのホルダーが連結されているものがある。手術具としては内視鏡や鉗子等が手術の種類や状況に応じて使用される。
In recent years, surgical operations using surgical support devices have become popular. Such a surgical support device includes a plurality of connecting arms that are rotatably or rotatably connected in order. Some have a holder connected to them to hold the ingredients. As surgical tools, endoscopes, forceps, etc. are used depending on the type and situation of the surgery.
手術支援装置において、複数の連結アームがそれぞれ所定の方向へ回動又は回転されると、連結アームの動作に伴って手術具の位置や姿勢が変化され、ホルダーに保持された手術具によって外科手術が行われる。
In a surgical support device, when a plurality of connecting arms are pivoted or rotated in a predetermined direction, the position and posture of the surgical tool are changed in accordance with the movement of the connecting arms, and the surgical tool held in the holder performs a surgical operation. will be held.
上記のような手術支援装置を用いた外科手術は、一般に、手術室に設置された手術支援装置をマスタースレーブ方式により術者(医師)が遠隔から操作することによって行われる。このような外科手術が行われる際には、手術具の位置や姿勢の基準点とされるピボット点が設定される。
A surgical operation using the above-mentioned surgical support device is generally performed by an operator (doctor) remotely operating the surgical support device installed in the operating room using a master-slave method. When performing such a surgical operation, a pivot point is set as a reference point for the position and posture of the surgical instrument.
ピボット点は患者の体腔に形成され手術具が挿入されるポートに略一致する位置であり、トロッカーが使用される場合にはトロッカーの位置に略一致される。従って、手術具が患者の体腔に挿入される状態においては、手術具の一部が常にピボット点を通るように手術具の位置や姿勢が制御され、手術具の一部がピボット点を通ることにより患者の体表付近の組織に対する負荷の発生が防止されて安全性が確保される。
The pivot point is a position that approximately corresponds to a port formed in the patient's body cavity into which a surgical tool is inserted, and when a trocar is used, it approximately corresponds to the position of the trocar. Therefore, when a surgical instrument is inserted into a patient's body cavity, the position and posture of the surgical instrument are controlled so that a part of the surgical instrument always passes through the pivot point; This prevents the occurrence of a load on tissues near the patient's body surface, thereby ensuring safety.
上記のような手術支援装置には、手術時に、クランパーによって手術台に固定された状態で使用されるものがある(例えば、特許文献1及び特許文献2参照)。また、このような手術支援装置においては、クランパーによってスタンド(台車)に固定されスタンドが手術台の周囲に設置された状態で使用可能にされる場合もある。
Some of the surgical support devices described above are used while being fixed to the operating table with a clamper during surgery (see, for example, Patent Document 1 and Patent Document 2). Further, such a surgical support device may be fixed to a stand (carriage) by a clamper and can be used with the stand installed around the operating table.
ところで、手術においては、患者の体型や術式等に応じ、使用される手術支援装置の望ましい高さが存在し、このような望ましい高さにおいて手術支援装置が使用されることにより使い勝手が高まり手術が適正かつ迅速に行われる。
By the way, in surgery, there is a desirable height of the surgical support device used depending on the patient's body shape, surgical method, etc., and using the surgical support device at such a desirable height increases usability and improves the surgical performance. is carried out appropriately and promptly.
また、ベース本体がスタンドに固定された状態で使用される場合には、手術支援装置の各部が手術台に干渉することなくスタンドが可能な限り手術台に近付いた状態で使用され使い勝手が高められることも望まれる。
Additionally, when the base body is used with the base body fixed to the stand, each part of the surgical support device does not interfere with the operating table, and the stand is used as close to the operating table as possible, increasing usability. It is also desired that
そこで、本発明手術支援装置は、手術台に固定される状態とスタンドに固定される状態の何れの状態においても使い勝手の向上を図ることを目的とする。
Therefore, it is an object of the present invention to improve the usability of the surgical support device in both the state in which it is fixed to a surgical table and the state in which it is fixed to a stand.
本発明に係る手術支援装置は、複数の連結アームと前記連結アームに支持されたホルダーと前記連結アームが連結された固定ベースとを備え、前記固定ベースは内部に所定の各部が配置されたベース本体と少なくとも一部がベース本体から突出され手術台に固定可能なクランパーとを有し、前記クランパーの前記ベース本体に対する上下方向における位置が変更可能にされたものである。
The surgical support device according to the present invention includes a plurality of connecting arms, a holder supported by the connecting arms, and a fixed base to which the connecting arms are connected, and the fixed base is a base in which predetermined parts are arranged. It has a main body and a clamper, at least a portion of which protrudes from the base main body and can be fixed to a surgical table, and the position of the clamper in the vertical direction with respect to the base main body can be changed.
これにより、手術台に固定される状態とスタンドに固定される状態の何れの状態においてもクランパーのベース本体に対する上下方向における位置が変更可能にされる。
As a result, the position of the clamper in the vertical direction relative to the base body can be changed in either the state where it is fixed to the operating table or the state where it is fixed to the stand.
本発明によれば、固定ベースが手術台に固定される状態とスタンドに固定される状態の何れの状態においてもクランパーのベース本体に対する上下方向における位置が変更可能にされるため、手術台に固定される状態において手術支援装置を最適な高さに設定することができ、スタンドに固定される状態においてクランパーを取り外して手術台に干渉しないようにすることができ、何れの状態においても使い勝手の向上を図ることができる。
According to the present invention, the position of the clamper in the vertical direction with respect to the base body can be changed in both the state in which the fixed base is fixed to the operating table and the state in which it is fixed to the stand, so that the clamper is fixed to the operating table. The surgical support device can be set at the optimal height when the surgical support device is being used, and the clamper can be removed when it is fixed to the stand so that it does not interfere with the operating table, improving usability in any situation. can be achieved.
以下に、本発明手術支援装置を実施するための形態について添付図面を参照して説明する。
Hereinafter, embodiments for implementing the surgical support device of the present invention will be described with reference to the accompanying drawings.
尚、以下に示す前後上下左右の方向は説明の便宜上のものであり、本発明の実施に関しては、これらの方向に限定されることはない。
Note that the front, rear, top, bottom, left and right directions shown below are for convenience of explanation, and the implementation of the present invention is not limited to these directions.
<手術支援装置等の概略構成>
先ず、手術支援装置1等の概略構成について説明する(図1及び図2参照)。 <Schematic configuration of surgical support equipment, etc.>
First, the schematic configuration of thesurgical support device 1 and the like will be described (see FIGS. 1 and 2).
先ず、手術支援装置1等の概略構成について説明する(図1及び図2参照)。 <Schematic configuration of surgical support equipment, etc.>
First, the schematic configuration of the
手術室には手術台100が設置され、手術台100には患者200が、例えば、仰向けの状態で横たえられている。手術台100の側部には固定用レール100aが設けられている。患者200の体腔201、例えば、腹壁201aにはポート202が形成される。ポート202には外科手術が行われるときに後述する手術具の一部が挿入される。ポート202は手術具の一部が挿入される小孔である。
An operating table 100 is installed in the operating room, and a patient 200 is lying on the operating table 100, for example, in a supine state. A fixing rail 100a is provided on the side of the operating table 100. A port 202 is formed in the body cavity 201 of the patient 200, for example, the abdominal wall 201a. A portion of a surgical tool, which will be described later, is inserted into the port 202 when a surgical operation is performed. Port 202 is a small hole into which a portion of a surgical tool is inserted.
手術支援装置1は装置本体2とホルダー3を有している。装置本体2の内部には、例えば、図示しない一つの電動モーターと図示しない複数の空気圧アクチュエーターとが配置されている。
The surgical support device 1 has a device main body 2 and a holder 3. Inside the device main body 2, for example, one electric motor (not shown) and a plurality of pneumatic actuators (not shown) are arranged.
装置本体2は手術台100に固定可能にされた固定ベース4と固定ベース4に連結されたアーム体5とを有している。
The device main body 2 has a fixed base 4 that can be fixed to the operating table 100 and an arm body 5 connected to the fixed base 4.
固定ベース4は内部に所定の各機構等が設けられた略直方体状のベース本体6とベース本体6に回転可能に支持された台座7と一部を除く部分がベース本体6から突出されたクランパー8とを有している。固定ベース4は台座7がベース本体6に垂直方向に延びる軸S1を支点として回転可能に支持されている。台座7は、例えば、電動モーターの駆動力によって固定ベース4に対して回転される。
The fixed base 4 includes a substantially rectangular parallelepiped-shaped base body 6 in which various predetermined mechanisms are provided, a pedestal 7 rotatably supported by the base body 6, and a clamper whose parts except a part protrude from the base body 6. 8. The fixed base 4 is rotatably supported by a pedestal 7 about an axis S1 extending perpendicularly to the base body 6 as a fulcrum. The pedestal 7 is rotated relative to the fixed base 4 by, for example, the driving force of an electric motor.
アーム体5は第1の連結アーム9と第2の連結アーム10と第3の連結アーム11を有している。尚、アーム体5における連結アームの数は三つに限られることはなく、複数であればよく、二つでも四つ以上であってもよい。
The arm body 5 has a first connecting arm 9, a second connecting arm 10, and a third connecting arm 11. Note that the number of connecting arms in the arm body 5 is not limited to three, and may be a plurality of connecting arms, and may be two or four or more.
第1の連結アーム9は長手方向における一端部が第1の連結部9aとして設けられ、長手方向における他端部が第2の連結部9bとして設けられている。第1の連結アーム9は第1の連結部9aが台座7に連結され、水平方向に延びる軸S2を支点として台座7に対して回動可能にされている。第1の連結アーム9は、例えば、コンプレッサーから供給される圧縮空気によって動作される空気圧アクチュエーターにより台座7に対して回動される。
One end of the first connecting arm 9 in the longitudinal direction is provided as a first connecting portion 9a, and the other end in the longitudinal direction is provided as a second connecting portion 9b. The first connecting arm 9 has a first connecting portion 9a connected to the pedestal 7, and is rotatable relative to the pedestal 7 about a horizontally extending axis S2 as a fulcrum. The first connecting arm 9 is rotated relative to the base 7 by, for example, a pneumatic actuator operated by compressed air supplied from a compressor.
第2の連結アーム10は長手方向における一端部が第1の連結部10aとして設けられ、長手方向における他端部が第2の連結部10bとして設けられている。第2の連結アーム10は第1の連結部10aが第1の連結アーム9の第2の連結部9bに連結され、水平方向に延びる軸S3を支点として第1の連結アーム9に対して回動可能にされる。第2の連結アーム10は、例えば、コンプレッサーから供給される圧縮空気によって動作される空気圧アクチュエーターにより第1の連結アーム9に対して回動される。
The second connection arm 10 has one end in the longitudinal direction provided as a first connection part 10a, and the other end in the longitudinal direction provided as a second connection part 10b. The second connecting arm 10 has a first connecting part 10a connected to a second connecting part 9b of the first connecting arm 9, and rotates with respect to the first connecting arm 9 about an axis S3 extending in the horizontal direction. be made movable. The second connecting arm 10 is rotated relative to the first connecting arm 9 by a pneumatic actuator operated by compressed air supplied from a compressor, for example.
第3の連結アーム11は長手方向における一端部が第1の連結部11aとして設けられ、長手方向における他端部が第2の連結部11bとして設けられている。第2の連結部11bは、例えば、二つの腕部によって構成されている。第3の連結アーム11は第1の連結部11aが第2の連結アーム10の第2の連結部10bに連結され、軸S3に直交する方向に延びる軸S4を支点として第2の連結アーム10に対して回転可能にされる。第3の連結アーム11は、例えば、電動モーターや空気圧アクチュエーターの駆動力等の外部からの駆動力によっては回転されず、自重や第1の連結アーム9や第2の連結アーム10等の他の動作に応じて回転されるフリーな回転動作を行う部分である。
One end of the third connecting arm 11 in the longitudinal direction is provided as a first connecting part 11a, and the other end in the longitudinal direction is provided as a second connecting part 11b. The second connecting portion 11b is composed of, for example, two arm portions. In the third connecting arm 11, the first connecting part 11a is connected to the second connecting part 10b of the second connecting arm 10, and the second connecting arm 10 is connected to the axis S4 extending in a direction orthogonal to the axis S3 as a fulcrum. Rotatable with respect to. The third connecting arm 11 is not rotated by an external driving force such as the driving force of an electric motor or a pneumatic actuator, and is not rotated by its own weight or other forces such as the first connecting arm 9 or the second connecting arm 10. This is a part that rotates freely according to the movement.
ホルダー3は第3の連結アーム11の第2の連結部11bに回動可能に支持(連結)されている。ホルダー3は軸S4に直交する方向に延びる軸S5を支点として第3の連結アーム11に対して回動可能にされている。ホルダー3は、例えば、電動モーターや空気圧アクチュエーターの駆動力等の外部からの駆動力によっては回転されず、自重や第1の連結アーム9や第2の連結アーム10や第3の連結アーム11等の他の動作に応じて回動されるフリーな回動動作を行う部分である。
The holder 3 is rotatably supported (connected) to the second connecting portion 11b of the third connecting arm 11. The holder 3 is rotatable relative to the third connecting arm 11 about an axis S5 extending in a direction perpendicular to the axis S4. The holder 3 is not rotated by an external driving force such as the driving force of an electric motor or a pneumatic actuator, but is rotated by its own weight, the first connecting arm 9, the second connecting arm 10, the third connecting arm 11, etc. It is a part that performs a free rotational movement that rotates in response to other movements.
ホルダー3は一部が回転可能にされ、回転されないベース筒部12とベース筒部12に回転可能に支持された回転部13とベース筒部12に取り付けられた連結筒部14とを有している(図3参照)。
The holder 3 has a base cylinder part 12 which is partially rotatable and is not rotated, a rotating part 13 rotatably supported by the base cylinder part 12, and a connecting cylinder part 14 attached to the base cylinder part 12. (See Figure 3).
回転部13は一部がベース筒部12と連結筒部14の内部に位置され、後端部がベース筒部12の後側に位置されている。回転部13はベース筒部12と連結筒部14に対して軸S5に直交する軸S6の軸回り方向へ回転可能にされている。回転部13は、例えば、コンプレッサーから供給される圧縮空気によって動作される空気圧アクチュエーターにより回転可能にされると共に手動によっても回転可能にされている。
A part of the rotating part 13 is located inside the base cylindrical part 12 and the connecting cylindrical part 14, and a rear end part is located on the rear side of the base cylindrical part 12. The rotating part 13 is rotatable relative to the base cylinder part 12 and the connecting cylinder part 14 in a direction around an axis S6 orthogonal to the axis S5. The rotating part 13 is rotatable by, for example, a pneumatic actuator operated by compressed air supplied from a compressor, and can also be rotated manually.
ホルダー3の内部には図示しないロック機構が配置されている。連結筒部14にはロック解除釦14aが配置されている。回転部13の後端部には切替釦13aが配置されている。切替釦13aは回転部13の回転を行うための駆動力を切り替える機能を有している。
A locking mechanism (not shown) is arranged inside the holder 3. A lock release button 14a is arranged on the connecting cylinder portion 14. A switching button 13a is arranged at the rear end of the rotating section 13. The switching button 13a has a function of switching the driving force for rotating the rotating section 13.
ホルダー3において、切替釦13aが操作されている状態においては回転部13が手動により回転可能にされる。一方、切替釦13aが操作されていない状態においては回転部13が空気圧アクチュエーターの駆動力により回転可能にされる。
In the holder 3, when the switching button 13a is operated, the rotating part 13 is manually rotatable. On the other hand, when the switching button 13a is not operated, the rotating part 13 is made rotatable by the driving force of the pneumatic actuator.
上記のように、手術支援装置1においては、軸S1から軸S6までの6軸で各部が回転可能又は回動可能な構成にされているため、ホルダー3に保持される手術具の向き及び位置(姿勢)の自由度が高く、手術を高い精度で迅速に行うことができる。特に、軸S4と軸S5においてフリーな回転動作又は回動動作が行われ軸S4と軸S5が直交するため、ポート202に挿入された手術具の向きや位置が変化されたときや患者200の呼吸状態等によりポート202の向きや位置が変化されたときに患者200の体表付近の組織に対する負荷を低減することができる。
As mentioned above, in the surgical support device 1, each part is configured to be rotatable or rotatable about six axes from the axis S1 to the axis S6, so the orientation and position of the surgical tool held in the holder 3 It has a high degree of freedom (posture) and can perform surgery quickly and with high precision. Particularly, since free rotational or rotational movement is performed on the axes S4 and S5 and the axes S4 and S5 are perpendicular to each other, when the direction or position of the surgical instrument inserted into the port 202 is changed or when the patient 200 When the direction or position of the port 202 is changed due to breathing conditions or the like, the load on tissues near the body surface of the patient 200 can be reduced.
また、手術支援装置1においては、アーム体5の手術具から最も遠距離の位置における軸S1での回転が電動モーターの駆動力によって行われ軸S1より手術具に近い位置における軸S2と軸S3と軸S6での回転又は回動が空気圧アクチュエーターの駆動力によって行われる。
In the surgical support device 1, rotation of the arm body 5 on the axis S1 at the farthest position from the surgical tool is performed by the driving force of the electric motor, and the axis S2 and the axis S3 at a position closer to the surgical tool than the axis S1 are rotated. The rotation or rotation about the axis S6 is performed by the driving force of the pneumatic actuator.
従って、電動モーターの駆動力より患者200に対する負荷が小さい空気圧アクチュエーターの駆動力によって手術具に近い位置においてアーム体5の動作が行われるため、患者200の体表付近の組織に対する負荷を一層低減することができる。
Therefore, the arm body 5 is operated at a position close to the surgical instrument by the driving force of the pneumatic actuator, which has a smaller load on the patient 200 than the driving force of the electric motor, further reducing the load on the tissues near the body surface of the patient 200. be able to.
さらに、空気圧アクチュエーターの駆動力によるアーム体5の回転又は回動の箇所が電動モーターの駆動力によるアーム体5の回転の箇所より多くされていることによっても、患者200の体表付近の組織に対する負荷の低減を図ることができる。
Furthermore, since the arm body 5 is rotated or pivoted at more locations due to the driving force of the pneumatic actuator than the locations where the arm body 5 is rotated due to the driving force of the electric motor, the tissue near the body surface of the patient 200 is It is possible to reduce the load.
尚、手術支援装置1においては、電動モーター又は空気圧アクチュエーターに代えて高精度の位置決めが可能な圧電モーター等の超音波モーターが用いられていてもよい。超音波モーターが用いられることにより、手術支援装置1における省電力化や小型化を図ることが可能である。
Note that in the surgical support device 1, an ultrasonic motor such as a piezoelectric motor capable of highly accurate positioning may be used instead of the electric motor or pneumatic actuator. By using the ultrasonic motor, it is possible to save power and downsize the surgical support device 1.
<固定ベースの具体的構成等>
以下に、固定ベース4の具体的な構成等について説明する(図2乃至図8参照)。 <Specific configuration of fixed base, etc.>
The specific structure of the fixedbase 4 will be described below (see FIGS. 2 to 8).
以下に、固定ベース4の具体的な構成等について説明する(図2乃至図8参照)。 <Specific configuration of fixed base, etc.>
The specific structure of the fixed
上記したように、固定ベース4はベース本体6と台座7とクランパー8を有している(図2及び図3参照)。
As described above, the fixed base 4 includes the base body 6, the pedestal 7, and the clamper 8 (see FIGS. 2 and 3).
ベース本体6は略直方体状に形成された外筐15と外筐15の内部に配置された所定の各機構等とを有し、外筐15が前面部16と上面部17と一対の側面部18と図示しない下面部と図示しない後面部とによって構成されている(図3及び図4参照)。
The base main body 6 has an outer casing 15 formed in a substantially rectangular parallelepiped shape and various predetermined mechanisms arranged inside the outer casing 15. 18, a lower surface portion (not shown), and a rear surface portion (not shown) (see FIGS. 3 and 4).
前面部16には複数の位置決め孔16aが形成されている。位置決め孔16aは、例えば、上下に離隔して三つが形成されている。前面部16には複数の配置孔16bが形成されている。配置孔16bは位置決め孔16aの左右方向における外側で稍下側に形成されている。従って、配置孔16bは位置決め孔16aの左右にそれぞれ三つずつが形成されている。
A plurality of positioning holes 16a are formed in the front part 16. For example, three positioning holes 16a are formed vertically apart from each other. A plurality of arrangement holes 16b are formed in the front part 16. The arrangement hole 16b is formed on the outer side and slightly below the positioning hole 16a in the left-right direction. Therefore, three placement holes 16b are formed on each side of the positioning hole 16a.
尚、ベース本体6においては、位置決め孔16aの数は複数であれば任意であり、配置孔16bはそれぞれの位置決め孔16aの左右に一つずつが形成される。
In the base body 6, the number of positioning holes 16a is arbitrary as long as it is plural, and one arrangement hole 16b is formed on each side of each positioning hole 16a.
ベース本体6には一対の側面部18からそれぞれ外方に突出された固定用突部19が設けられている。固定用突部19は側面部18の上端寄りの位置に設けられている。
The base body 6 is provided with fixing protrusions 19 that protrude outward from a pair of side surfaces 18, respectively. The fixing protrusion 19 is provided at a position near the upper end of the side surface portion 18.
ベース本体6には一部が配置孔16bに挿入されて配置されたロック部材20が設けられている(図4参照)。ロック部材20は軸方向が前後方向にされた筒状に形成され、前端部が配置孔16bに挿入された状態にされている。ロック部材20の内部の空間は挿入孔21として形成されている。ロック部材20の内周面の軸方向における中間部には後方へ行くに従って径が大きくなる傾斜面が形成され、この傾斜面がロック用係合部20aとされている。挿入孔21はロック用係合部20aより前側の部分が後側の部分より径の小さい変位規制部21aとして形成されている。
The base body 6 is provided with a locking member 20 that is partially inserted into the placement hole 16b (see FIG. 4). The locking member 20 is formed into a cylindrical shape with its axial direction extending in the front-rear direction, and its front end is inserted into the arrangement hole 16b. A space inside the locking member 20 is formed as an insertion hole 21. An inclined surface whose diameter increases toward the rear is formed in the axially intermediate portion of the inner circumferential surface of the locking member 20, and this inclined surface serves as a locking engagement portion 20a. The insertion hole 21 is formed as a displacement regulating part 21a in which a portion on the front side of the locking engagement portion 20a has a smaller diameter than a portion on the rear side.
ベース本体6には後面部から図示しないエアー吸入管が突出されている。エアー吸入管は吸入チューブを介してコンプレッサーに接続される。従って、固定ベース4の内部にはコンプレッサーから圧縮空気が供給される。固定ベース4の内部に供給された圧縮空気は固定ベース4の内部を通ってアーム体5の内部へ向かい第1の連結アーム9と第2の連結アーム10とホルダー3を回動又は回転させる駆動力として用いられる。
An air suction pipe (not shown) protrudes from the rear surface of the base body 6. The air suction pipe is connected to the compressor via a suction tube. Therefore, compressed air is supplied to the inside of the fixed base 4 from the compressor. The compressed air supplied to the inside of the fixed base 4 passes through the inside of the fixed base 4 to the inside of the arm body 5, and is driven to rotate or rotate the first connecting arm 9, the second connecting arm 10, and the holder 3. Used as a force.
クランパー8はクランプベース22と下側クランプ部23とクランプレバー24と一対の被ロック部材25を有している(図4乃至図6参照)。
The clamper 8 has a clamp base 22, a lower clamp portion 23, a clamp lever 24, and a pair of locked members 25 (see FIGS. 4 to 6).
クランプベース22は、前後に貫通された略矩形の枠状部26と、枠状部26の上端部から前方に突出された上側クランプ部27と、枠状部26の左右両側部からそれぞれ前方に突出された一対の支持板部28と、枠状部26の後端部から支持板部28の後端部に亘る部分からそれぞれ左右方向における外方に突出された一対の取付用突部29とを有している。
The clamp base 22 includes a substantially rectangular frame portion 26 that is penetrated from front to back, an upper clamp portion 27 that protrudes forward from the upper end of the frame portion 26, and an upper clamp portion 27 that extends forward from both left and right sides of the frame portion 26, respectively. a pair of protruding support plate parts 28; a pair of mounting protrusions 29 protruding outward in the left-right direction from a portion extending from the rear end of the frame-shaped part 26 to the rear end of the support plate part 28; have.
上側クランプ部27には上下に貫通された図示しない螺孔が形成されている。上側クランプ部27の前端寄りの位置には下方及び側方に開口された上側挿入凹部27aが形成されている。
A screw hole (not shown) is formed in the upper clamp part 27 and extends vertically. An upper insertion recess 27a that is open downward and laterally is formed at a position near the front end of the upper clamp portion 27.
支持板部28は前端が上側クランプ部27の前端より後方に位置されている。支持板部28には左右方向において内方に突出されたストッパー軸28aが設けられている。
The front end of the support plate part 28 is located rearward than the front end of the upper clamp part 27. The support plate portion 28 is provided with a stopper shaft 28a that projects inward in the left-right direction.
取付用突部29には前後に貫通された軸挿通孔30が形成され、軸挿通孔30は前側に位置された大径部31と後側に位置された小径部32とから成る(図4参照)。取付用突部29には大径部31と小径部32の境界部分に前方を向く円環状の段差面33が形成されている。
A shaft insertion hole 30 is formed in the mounting protrusion 29, and the shaft insertion hole 30 consists of a large diameter portion 31 located on the front side and a small diameter portion 32 located on the rear side (FIG. 4). reference). The mounting protrusion 29 has an annular stepped surface 33 facing forward at the boundary between the large diameter portion 31 and the small diameter portion 32 .
クランパー8には枠状部26から後方に突出された位置決めピン34が設けられている(図6参照)。
The clamper 8 is provided with a positioning pin 34 that projects rearward from the frame portion 26 (see FIG. 6).
下側クランプ部23は上側クランプ部27の下側において一対の支持板部28に回動可能に支持されている。下側クランプ部23は一対の支持板部28間に位置された本体部35と本体部35から左右方向における外側に突出された一対の被支持軸部36とを有している。本体部35は扁平な形状に形成され、前端部に上方及び側方に開口された下側挿入凹部35aを有している。本体部35は後端部が被押圧部35bとして設けられている。下側クランプ部23は被支持軸部36が一対の支持板部28に支持されることにより被支持軸部36を支点としてクランプベース22に対して回動可能にされている。
The lower clamp part 23 is rotatably supported by a pair of support plate parts 28 below the upper clamp part 27. The lower clamp portion 23 has a main body portion 35 located between a pair of support plate portions 28 and a pair of supported shaft portions 36 protruding outward from the main body portion 35 in the left-right direction. The main body portion 35 is formed in a flat shape and has a lower insertion recess 35a that is open upwardly and laterally at the front end. The rear end portion of the main body portion 35 is provided as a pressed portion 35b. The lower clamp portion 23 is rotatable with respect to the clamp base 22 with the supported shaft portion 36 as a fulcrum as the supported shaft portion 36 is supported by the pair of support plate portions 28 .
被支持軸部36は下側挿入凹部35aと被押圧部35bの間の部分から突出されている。被支持軸部36には捩じりコイルバネ37のコイル部37aが支持されている。捩じりコイルバネ37は一方の腕部37bが支持板部28に係合され他方の腕部37cが本体部35に係合されている。従って、下側クランプ部23は捩じりコイルバネ37の付勢力によって被押圧部35bが上側クランプ部27に近付く方向へ付勢されている。下側クランプ部23は本体部35が支持板部28のストッパー軸28aに接することにより捩じりコイルバネ37によって付勢された方向への回動が規制される。
The supported shaft portion 36 protrudes from a portion between the lower insertion recess 35a and the pressed portion 35b. A coil portion 37a of a torsion coil spring 37 is supported by the supported shaft portion 36. One arm portion 37b of the torsion coil spring 37 is engaged with the support plate portion 28, and the other arm portion 37c is engaged with the main body portion 35. Therefore, the lower clamp part 23 is biased by the biasing force of the torsion coil spring 37 in the direction in which the pressed part 35b approaches the upper clamp part 27. The rotation of the lower clamp portion 23 in the direction urged by the torsion coil spring 37 is restricted by the main body portion 35 coming into contact with the stopper shaft 28a of the support plate portion 28.
クランプレバー24は回転操作部24aと螺軸部24bによって構成され、螺軸部24bが回転操作部24aから下方に突出されている。螺軸部24bの外周面には螺溝が形成されている。
The clamp lever 24 is composed of a rotational operation section 24a and a screw shaft section 24b, and the screw shaft section 24b projects downward from the rotation operation section 24a. A screw groove is formed on the outer peripheral surface of the screw shaft portion 24b.
クランプレバー24は螺軸部24bが上側クランプ部27を貫通された状態で螺孔に螺合され、螺軸部24bの下端が本体部35の被押圧部35bに上方から接した状態にされている。本体部35は捩じりコイルバネ37の付勢力によって被押圧部35bが螺軸部24bの下端に押し付けられている。従って、クランプレバー24の回転操作部24aが手動により回転操作されると、螺孔に螺合されている螺溝が螺軸部24bの軸方向へ送られ、螺軸部24bが回転操作部24aの回転方向に応じて上下動され、下側クランプ部23が被支持軸部36を支点としてクランプベース22に対して回動される。
The clamp lever 24 is screwed into the screw hole with the screw shaft portion 24b passing through the upper clamp portion 27, and the lower end of the screw shaft portion 24b is in contact with the pressed portion 35b of the main body portion 35 from above. There is. The pressed portion 35b of the main body portion 35 is pressed against the lower end of the helical shaft portion 24b by the urging force of the torsion coil spring 37. Therefore, when the rotation operating portion 24a of the clamp lever 24 is manually rotated, the threaded groove threaded into the screw hole is sent in the axial direction of the threaded shaft portion 24b, and the threaded portion 24b is rotated by the rotation operating portion 24a. The lower clamp portion 23 is rotated with respect to the clamp base 22 using the supported shaft portion 36 as a fulcrum.
被ロック部材25は前後に延びる軸状に形成されている(図6参照)。被ロック部材25は前端部を除く前側の略半分の部分が第1の挿入部38として設けられ後側の略半分の部分が第2の挿入部39として設けられている。第1の挿入部38は径が第2の挿入部39の径より大きくされ取付用突部29に形成された軸挿通孔30の大径部31の径より一回り小さくされている。第2の挿入部39は径が取付用突部29に形成された軸挿通孔30の小径部32の径より一回り小さくされロック部材20の変位規制部21aの径と略同じにされている。
The locked member 25 is formed into a shaft shape that extends back and forth (see FIG. 6). In the locked member 25, approximately half of the front side excluding the front end is provided as a first insertion section 38, and approximately half of the rear side thereof is provided as a second insertion section 39. The diameter of the first insertion portion 38 is larger than the diameter of the second insertion portion 39, and is one size smaller than the diameter of the large diameter portion 31 of the shaft insertion hole 30 formed in the mounting projection 29. The diameter of the second insertion portion 39 is one size smaller than the diameter of the small diameter portion 32 of the shaft insertion hole 30 formed in the mounting protrusion 29, and is approximately the same as the diameter of the displacement regulating portion 21a of the locking member 20. .
第2の挿入部39の後端寄りの部分には複数のロック球40が周方向に離隔して変位可能な状態で支持されている(図4参照)。ロック球40は第2の挿入部39の径方向において変位可能にされ、第2の挿入部39から最も飛び出す飛出位置と第2の挿入部39の内部に最も引き込まれる引込位置との間で変位される。ロック球40は第2の挿入部39の内部に配置された図示しない付勢バネによって引込位置から飛出位置へ向かう方向へ付勢されている。
A plurality of lock balls 40 are supported in a portion near the rear end of the second insertion portion 39 so as to be displaceable and spaced apart in the circumferential direction (see FIG. 4). The locking ball 40 is displaceable in the radial direction of the second insertion section 39, and is between a protruding position where it protrudes the most from the second insertion section 39 and a retracted position where it is most drawn into the inside of the second insertion section 39. Displaced. The locking ball 40 is biased in a direction from the retracted position toward the ejected position by a biasing spring (not shown) disposed inside the second insertion portion 39 .
上記のように構成された固定ベース4において、クランパー8はベース本体6に以下のようにして取り付けられる(図4、図7及び図8参照)。
In the fixed base 4 configured as described above, the clamper 8 is attached to the base body 6 in the following manner (see FIGS. 4, 7, and 8).
先ず、クランパー8は位置決めピン34がベース本体6の位置決め孔16aに挿入され、ベース本体6に対して位置決めされる。このとき位置決めピン34は上下に離隔して形成された何れか一つの位置決め孔16aに挿入されるため、クランパー8をベース本体6に対して必要に応じた高さに取り付けることが可能である。
First, the clamper 8 is positioned with respect to the base body 6 by inserting the positioning pin 34 into the positioning hole 16a of the base body 6. At this time, the positioning pin 34 is inserted into one of the positioning holes 16a formed vertically apart from each other, so that the clamper 8 can be attached to the base body 6 at a desired height.
クランパー8がベース本体6に位置決めされた状態においては、取付用突部29に形成された軸挿通孔30がロック部材20の挿入孔21に前後で一致される(図4参照)。
When the clamper 8 is positioned on the base body 6, the shaft insertion hole 30 formed in the mounting protrusion 29 is aligned with the insertion hole 21 of the locking member 20 from the front to the rear (see FIG. 4).
次に、一対の被ロック部材25がそれぞれ取付用突部29に形成された軸挿通孔30とロック部材20の挿入孔21に順に挿入される。被ロック部材25が軸挿通孔30から挿入孔21に挿入され第2の挿入部39が挿入孔21の変位規制部21aに位置されると、飛出位置にあったロック球40が変位規制部21aによって飛出位置へ向けての変位が規制され付勢バネの付勢力に反して引込位置へ向けて変位される(図7参照)。被ロック部材25が軸挿通孔30のさらに奥側へ挿入されると、第1の挿入部38の後面が軸挿通孔30の段差面33に近接又は当接され、ロック球40が変位規制部21aの後側に位置されて変位の規制が解除され付勢バネの付勢力によって飛出位置へ向けて変位されロック用係合部20aに係合される(図8参照)。従って、ロック部材20によってクランパー8がベース本体6にロックされる。
Next, the pair of locked members 25 are sequentially inserted into the shaft insertion hole 30 formed in the mounting protrusion 29 and the insertion hole 21 of the locking member 20, respectively. When the locked member 25 is inserted into the insertion hole 21 from the shaft insertion hole 30 and the second insertion part 39 is positioned in the displacement restriction part 21a of the insertion hole 21, the lock ball 40 in the protruding position moves into the displacement restriction part. The displacement toward the protruding position is regulated by 21a, and the displacement toward the retracted position is performed against the biasing force of the biasing spring (see FIG. 7). When the locked member 25 is inserted further into the shaft insertion hole 30, the rear surface of the first insertion portion 38 comes close to or comes into contact with the stepped surface 33 of the shaft insertion hole 30, and the locking ball 40 moves into the displacement regulating portion. 21a, the restriction on displacement is released, and by the biasing force of the biasing spring it is displaced toward the protruding position and engaged with the locking engagement portion 20a (see FIG. 8). Therefore, the clamper 8 is locked to the base body 6 by the locking member 20.
ロック球40が変位規制部21aの後側に位置されてロック用係合部20aに係合されるときには、ロック球40の変位が操作者の指に伝達され、操作者においてロック部材20によるクランパー8のベース本体6に対するロックが完了したことが認識される。また、ロック球40がロック用係合部20aに係合されるときにロック球40の変位に伴い音が生じる構成にされていてもよく、この場合には操作者において音の聞き取りによりロック部材20によるクランパー8のベース本体6に対するロックが完了したことが認識される。
When the locking ball 40 is positioned behind the displacement regulating portion 21a and engaged with the locking engaging portion 20a, the displacement of the locking ball 40 is transmitted to the operator's fingers, and the operator can use the clamping force of the locking member 20 to 8 is recognized to have been completely locked to the base body 6. Further, when the lock ball 40 is engaged with the locking engagement portion 20a, a sound may be generated as the lock ball 40 is displaced. It is recognized that locking of the clamper 8 to the base body 6 by the clamper 20 is completed.
上記のように、手術支援装置1においては、クランパー8に二つの被ロック部材25が設けられ、ベース本体6に被ロック部材25がそれぞれ係合されクランパー8をベース本体6にロックする二つのロック部材20が設けられている。
As described above, in the surgical support device 1, the two lockable members 25 are provided on the clamper 8, and the two lockable members 25 are respectively engaged with the base body 6 to lock the clamper 8 to the base body 6. A member 20 is provided.
従って、一方の被ロック部材25のロック部材20に対する係合が解除された状態でも他方の被ロック部材25がロック部材20に係合されクランパー8がベース本体6に保持された状態になるため、クランパー8のベース本体6からの不用意な脱落を防止することができる。
Therefore, even when one locked member 25 is disengaged from the locking member 20, the other locked member 25 is engaged with the locking member 20 and the clamper 8 is held on the base body 6. It is possible to prevent the clamper 8 from accidentally falling off from the base body 6.
また、ロック部材20が筒状に形成され、被ロック部材25が軸状に形成され、被ロック部材25がロック部材20に所定の位置まで挿通されることによりクランパー8がベース本体6にロックされる。
Further, the locking member 20 is formed in a cylindrical shape, the locked member 25 is formed in a shaft shape, and the clamper 8 is locked to the base body 6 by inserting the locked member 25 into the locking member 20 to a predetermined position. Ru.
従って、クランパー8は被ロック部材25がロック部材20に挿通されることによりベース本体6にロックされるため、クランパー8のベース本体6に対するロック作業を容易かつ確実に行うことができる。
Therefore, the clamper 8 is locked to the base body 6 by inserting the locked member 25 into the locking member 20, so that the clamper 8 can be locked to the base body 6 easily and reliably.
一方、クランパー8のベース本体6からの取り外しは、被ロック部材25を挿入孔21と軸挿通孔30から引き出してロック球40のロック用係合部20aへの係合を解除し、位置決めピン34を位置決め孔16aから引き出すことにより行うことができる。
On the other hand, to remove the clamper 8 from the base body 6, the member to be locked 25 is pulled out from the insertion hole 21 and the shaft insertion hole 30, the engagement of the locking ball 40 with the locking engagement portion 20a is released, and the positioning pin 34 is removed from the locking engagement portion 20a of the locking ball 40. This can be done by pulling it out from the positioning hole 16a.
尚、ロック部材20の内周面の一部と被ロック部材25の外周面の一部とに互いに螺合される螺溝部が形成され、両者の螺溝部が螺合された状態で被ロック部材25がロック部材20に対して回転されて被ロック部材25がロック部材20に対して軸方向へ移動される構成にされていてもよい。
Note that a threaded groove portion is formed in a part of the inner circumferential surface of the locking member 20 and a part of the outer circumferential surface of the locked member 25, and the threaded groove portions are screwed together. 25 may be rotated with respect to the locking member 20, and the locked member 25 may be moved in the axial direction with respect to the locking member 20.
<セパレーターの構成等>
続いて、ホルダー3に取り付けられるセパレーター41の構成等について説明する(図1、図2及び図9参照)。 <Separator configuration, etc.>
Next, the configuration of theseparator 41 attached to the holder 3 will be explained (see FIGS. 1, 2, and 9).
続いて、ホルダー3に取り付けられるセパレーター41の構成等について説明する(図1、図2及び図9参照)。 <Separator configuration, etc.>
Next, the configuration of the
ホルダー3にはセパレーター41が着脱可能にされている。セパレーター41は略円板状の取付部42と取付部42の厚み方向における一方の面から突出された挿通部43と取付部42の厚み方向における他方の面から突出された一対の係合部44とを有している。セパレーター41は挿通部43がホルダー3の前端部に挿入されてホルダー3にロック機構によってロックされた状態で取り付けられる。セパレーター41はホルダー3のロック解除釦14aが操作されることによりホルダー3に対するロックの解除が可能にされている。
A separator 41 is removably attached to the holder 3. The separator 41 includes a substantially disk-shaped mounting portion 42, an insertion portion 43 protruding from one surface of the mounting portion 42 in the thickness direction, and a pair of engaging portions 44 protruding from the other surface of the mounting portion 42 in the thickness direction. It has The separator 41 is attached to the holder 3 with the insertion portion 43 inserted into the front end of the holder 3 and locked by the locking mechanism. The separator 41 can be unlocked from the holder 3 by operating the lock release button 14a of the holder 3.
セパレーター41にはアダプター45が着脱可能にされている。アダプター45は、例えば、第1の部材46と第2の部材47が上下で結合されて成り、後端部がセパレーター41に係合されて取り付けられる被取付部48として設けられている。
An adapter 45 is detachably attached to the separator 41. The adapter 45 is made up of, for example, a first member 46 and a second member 47 coupled at the top and bottom, and is provided as an attached part 48 whose rear end is engaged with and attached to the separator 41.
アダプター45には手術具80が装着される。手術具80は、例えば、内視鏡を有するスコープユニットとして設けられ、内部に複数のレンズが配置されたシャフト部81とシャフト部81の一端部に結合されたヘッド部82とシャフト部81の中間部に結合されたライトガイド83とを有している。ヘッド部82の内部には図示しない撮像素子が配置されている。
A surgical tool 80 is attached to the adapter 45. The surgical tool 80 is provided, for example, as a scope unit having an endoscope, and includes a shaft portion 81 in which a plurality of lenses are arranged, a head portion 82 coupled to one end of the shaft portion 81, and an intermediate portion between the shaft portion 81. It has a light guide 83 coupled to the section. An image sensor (not shown) is arranged inside the head section 82 .
ヘッド部82には信号線や電源線である図示しないケーブルが接続され、ライトガイド83には光を導くための図示しないライドガイドケーブルが接続される。
Cables (not shown) serving as signal lines and power lines are connected to the head portion 82, and a ride guide cable (not shown) for guiding light is connected to the light guide 83.
手術具80はヘッド部82が第1の部材46と第2の部材47によって上下から挟持されることによりアダプター45に保持される。手術具80を保持したアダプター45は被取付部48が一対の係合部44間に挿入されて取付部42と係合部44に係合されることによりセパレーター41に取り付けられる。従って、手術具80はアダプター45とセパレーター41を介してホルダー3に保持される。
The surgical tool 80 is held by the adapter 45 by having the head portion 82 sandwiched between the first member 46 and the second member 47 from above and below. The adapter 45 holding the surgical tool 80 is attached to the separator 41 by inserting the attachment portion 48 between the pair of engagement portions 44 and engaging the attachment portion 42 and the engagement portion 44 . Therefore, the surgical tool 80 is held in the holder 3 via the adapter 45 and separator 41.
手術具80はシャフト部81の少なくとも先端部が患者200に形成されたポート202から体腔201の内部に挿入される。シャフト部81の先端部が体腔201の内部に挿入された状態において、シャフト部81の先端部から照明光が照射され、撮像素子によって体腔201の内部の状態が撮影される。
At least the distal end of the shaft portion 81 of the surgical tool 80 is inserted into the body cavity 201 through a port 202 formed in the patient 200. When the distal end of the shaft portion 81 is inserted into the body cavity 201, illumination light is emitted from the distal end of the shaft portion 81, and the state inside the body cavity 201 is photographed by the imaging device.
<スタンドの構成等>
次いで、固定ベース4が固定されるスタンド50の構成等について説明する(図3参照)。 <Stand configuration, etc.>
Next, the configuration of thestand 50 to which the fixed base 4 is fixed will be explained (see FIG. 3).
次いで、固定ベース4が固定されるスタンド50の構成等について説明する(図3参照)。 <Stand configuration, etc.>
Next, the configuration of the
手術支援装置1は、例えば、固定ベース4が台車としても利用可能なスタンド50に設置され、スタンド50によって滅菌室に搬送されて滅菌処理が行われた状態で手術室に搬送されて手術において使用可能にされる。
In the surgical support device 1, for example, the fixed base 4 is installed on a stand 50 that can also be used as a trolley, and is transported to a sterilization room by the stand 50, where it is sterilized, transported to an operating room, and used in a surgery. made possible.
スタンド50は複数の車輪51が支持された車台52と車台52に連結された連結ベース53と連結ベース53に連結された装置固定部54とを有している。連結ベース53と装置固定部54は車台52の上側に位置され、装置固定部54は連結ベース53に対する上下方向への位置の調整が可能にされている。従って、スタンド50においては、装置固定部54の高さを調整することにより手術支援装置1の高さを変更することができる。
The stand 50 has a chassis 52 on which a plurality of wheels 51 are supported, a connection base 53 connected to the chassis 52, and a device fixing part 54 connected to the connection base 53. The connection base 53 and the device fixing part 54 are located above the vehicle chassis 52, and the position of the device fixing part 54 can be adjusted in the vertical direction with respect to the connection base 53. Therefore, in the stand 50, the height of the surgical support device 1 can be changed by adjusting the height of the device fixing portion 54.
装置固定部54は上側の部分が下側の部分に対して後側に屈曲され、後側に屈曲された部分が使用者(搬送者)によって把持されるハンドル部54aとされている。装置固定部54にはハンドル部54aより下側に前方に突出された一対の固定用アーム部54bが左右に離隔して設けられている。
The upper part of the device fixing part 54 is bent rearward with respect to the lower part, and the rearward bent part is a handle part 54a that is grasped by the user (carrier). The device fixing portion 54 is provided with a pair of fixing arm portions 54b that protrude downward and forward from the handle portion 54a and are spaced apart from each other in the left and right directions.
固定ベース4のスタンド50への固定は、例えば、側面部18から外方に突出された一対の固定用突部19にそれぞれ固定部材55が取り付けられ、固定部材55が固定用アーム部54bに締結具56によって締結されることにより行われる。
The fixing base 4 is fixed to the stand 50 by, for example, attaching fixing members 55 to a pair of fixing protrusions 19 that protrude outward from the side surface 18, and fastening the fixing members 55 to the fixing arm portions 54b. This is done by fastening with the tool 56.
固定ベース4がスタンド50に固定され手術支援装置1がスタンド50に設置された状態においては、クランパー8がベース本体6を挟んでハンドル部54aと反対側に位置される。
When the fixed base 4 is fixed to the stand 50 and the surgical support device 1 is installed on the stand 50, the clamper 8 is positioned on the opposite side of the handle portion 54a with the base body 6 interposed therebetween.
<手術支援装置の使用状態等>
次に、手術支援装置1の使用状態等について説明する(図1及び図3参照)。 <Usage status of surgical support equipment, etc.>
Next, the usage status of thesurgical support device 1 will be explained (see FIGS. 1 and 3).
次に、手術支援装置1の使用状態等について説明する(図1及び図3参照)。 <Usage status of surgical support equipment, etc.>
Next, the usage status of the
手術支援装置1は、手術時に固定ベース4がクランパー8によって手術台100の固定用レール100aに固定された状態で使用可能にされている(図1参照)。
The surgical support device 1 can be used during surgery with the fixed base 4 fixed to the fixing rail 100a of the operating table 100 by the clamper 8 (see FIG. 1).
クランパー8は、上記したように、高さの異なる位置決め孔16aと挿入孔21を有しているため、位置決めピン34と被ロック部材25がそれぞれ何れかの位置決め孔16aと挿入孔21に挿入されており、クランパー8がベース本体6に対して必要に応じた高さに取り付けられてロックされている。
As described above, the clamper 8 has the positioning hole 16a and the insertion hole 21 with different heights, so that the positioning pin 34 and the locked member 25 are inserted into either the positioning hole 16a or the insertion hole 21, respectively. The clamper 8 is attached to the base body 6 at an appropriate height and locked.
クランパー8による固定用レール100aへの固定は、上側クランプ部27と下側クランプ部23の間に固定用レール100aが挿入された状態において、クランプレバー24が一方向へ回転操作されることにより行われる。クランプレバー24が回転操作されると、下側クランプ部23が一対の被支持軸部36を支点としてクランプベース22に対して下側挿入凹部35aが上側クランプ部27に近付く方向へ回動される。従って、上側クランプ部27の上側挿入凹部27aと下側クランプ部23の下側挿入凹部35aとの間に固定用レール100aが挿入されて上側クランプ部27と下側クランプ部23によって固定用レール100aが挟持されることにより固定ベース4がクランパー8によって固定用レール100aに固定される。
The clamper 8 is fixed to the fixing rail 100a by rotating the clamp lever 24 in one direction while the fixing rail 100a is inserted between the upper clamp part 27 and the lower clamp part 23. be exposed. When the clamp lever 24 is rotated, the lower clamp part 23 is rotated with respect to the clamp base 22 in a direction in which the lower insertion recess 35a approaches the upper clamp part 27 using the pair of supported shaft parts 36 as fulcrums. . Therefore, the fixing rail 100a is inserted between the upper insertion recess 27a of the upper clamp part 27 and the lower insertion recess 35a of the lower clamp part 23, and the fixing rail 100a is inserted between the upper clamp part 27 and the lower clamp part 23. By being clamped, the fixed base 4 is fixed to the fixing rail 100a by the clamper 8.
一方、クランプレバー24が上記とは反対方向へ回転操作されて下側クランプ部23が回動されることにより、クランパー8を固定用レール100aから取り外して固定ベース4の固定用レール100aに対する固定状態を解除することができる。
On the other hand, by rotating the clamp lever 24 in the opposite direction to the above and rotating the lower clamp part 23, the clamper 8 is removed from the fixing rail 100a, and the fixed base 4 is fixed to the fixing rail 100a. can be canceled.
また、手術支援装置1は、上記したように、手術時に固定ベース4がスタンド50に固定された状態においても使用可能にされている(図3参照)。固定ベース4がスタンド50に固定された状態において手術支援装置1が使用される場合には、可能な限り手術支援装置1が手術台100に近付いた状態で使用されることが望ましい。
Further, as described above, the surgical support device 1 can be used even when the fixed base 4 is fixed to the stand 50 during surgery (see FIG. 3). When the surgical support device 1 is used with the fixed base 4 fixed to the stand 50, it is desirable to use the surgical support device 1 as close to the operating table 100 as possible.
手術支援装置1においては、ベース本体6にクランパー8が着脱可能にされており、固定ベース4がスタンド50に固定された状態において手術支援装置1が使用される場合にはクランパー8が不要であるため、この場合にクランパー8をベース本体6から取り外して手術支援装置1を使用することが可能である。従って、ベース本体6から突出されるクランパー8が取り外されることにより、その分、手術支援装置1とスタンド50を手術台100に近付けることが可能である。
In the surgical support device 1, the clamper 8 is removably attached to the base body 6, and the clamper 8 is not required when the surgical support device 1 is used with the fixed base 4 fixed to the stand 50. Therefore, in this case, it is possible to remove the clamper 8 from the base body 6 and use the surgical support device 1. Therefore, by removing the clamper 8 protruding from the base body 6, it is possible to move the surgical support device 1 and the stand 50 closer to the operating table 100.
また、手術時に固定ベース4がスタンド50に固定された状態において、クランパー8を手術台100に干渉しない位置、例えば、最も高さの低い位置にクランパー8を取り付けて手術支援装置1を使用することが可能であり、クランパー8を取り外して手術支援装置1を使用することも可能である。
Furthermore, when the fixed base 4 is fixed to the stand 50 during surgery, the surgical support device 1 can be used by attaching the clamper 8 to a position where it does not interfere with the operating table 100, for example, at the lowest position. It is also possible to remove the clamper 8 and use the surgical support device 1.
<まとめ>
以上に記載した通り、手術支援装置1においては、固定ベース4は内部に所定の各部が配置可能なベース本体6と少なくとも一部がベース本体6から突出され手術台100に固定されるクランパー8とを有し、クランパー8のベース本体6に対する上下方向における位置が変更可能にされている。 <Summary>
As described above, in thesurgical support device 1, the fixed base 4 includes a base main body 6 in which predetermined parts can be arranged, and a clamper 8 that at least partially protrudes from the base main body 6 and is fixed to the operating table 100. The position of the clamper 8 relative to the base body 6 in the vertical direction can be changed.
以上に記載した通り、手術支援装置1においては、固定ベース4は内部に所定の各部が配置可能なベース本体6と少なくとも一部がベース本体6から突出され手術台100に固定されるクランパー8とを有し、クランパー8のベース本体6に対する上下方向における位置が変更可能にされている。 <Summary>
As described above, in the
従って、固定ベース4が手術台100に固定される状態とスタンド50に固定される状態の何れの状態においてもクランパー8のベース本体6に対する上下方向における位置が変更可能である。これにより、固定ベース4が手術台100に固定される状態において手術支援装置1を最適な高さに設定することができると共にスタンド50に固定される状態においてクランパー8を取り外して手術台100に干渉しないようにすることができ、何れの状態においても手術支援装置1の使い勝手の向上を図ることができる。
Therefore, the position of the clamper 8 in the vertical direction relative to the base body 6 can be changed in both the state in which the fixed base 4 is fixed to the operating table 100 and the state in which it is fixed to the stand 50. As a result, the surgical support device 1 can be set at an optimal height when the fixed base 4 is fixed to the operating table 100, and the clamper 8 can be removed to interfere with the operating table 100 when the fixed base 4 is fixed to the stand 50. This makes it possible to improve the usability of the surgical support device 1 in any situation.
尚、上記にはクランパー8がベース本体6にロック部材20等によってロックされる例を示したが、例えば、モーターの駆動等によってクランパー8がベース本体6に対して上下方向へ移動可能にされてもよい。また、例えば、ボールネジを有する回転操作部等が用いられ、手動により回転操作部が回転操作されることによりクランパー8がベース本体6に対して上下方向へ移動可能にされてもよい。
Although the above example shows that the clamper 8 is locked to the base body 6 by the locking member 20 or the like, for example, the clamper 8 may be made vertically movable relative to the base body 6 by driving a motor or the like. Good too. Further, for example, a rotary operation section having a ball screw or the like may be used, and the clamper 8 may be made vertically movable with respect to the base body 6 by manually rotating the rotation operation section.
また、クランパー8がベース本体6に着脱可能にされているため、クランパー8をベース本体6から外した状態でベース本体6をスタンド50に固定して手術支援装置1を手術において使用したときに手術台100にクランパー8が干渉することがないため、手術支援装置1を手術台100に近付けて使用することが可能になり、手術支援装置1の一層の使い勝手の向上を図ることができる。
In addition, since the clamper 8 is removably attached to the base body 6, when the base body 6 is fixed to the stand 50 with the clamper 8 removed from the base body 6 and the surgical support device 1 is used in a surgery, it is possible to perform a surgical operation. Since the clamper 8 does not interfere with the table 100, the surgical support device 1 can be used close to the surgical table 100, and the usability of the surgical support device 1 can be further improved.
尚、クランパー8をベース本体6から外した状態でベース本体6をスタンド50に固定して手術支援装置1を手術において使用する場合には、スタンド50の高さ調整機構によって手術支援装置1の高さを患者200の体型や手術の方式等により変更することが可能である。また、クランパー8をベース本体6に取り付けた状態でクランパー8を手術台100の固定用レール100aに固定して手術支援装置1を手術において使用する場合には、クランパー8のベース本体6に対する取付位置を調整することによって手術支援装置1の高さを患者200の体型や手術の方式等により変更することが可能である。
In addition, when the base body 6 is fixed to the stand 50 with the clamper 8 removed from the base body 6 and the surgical support device 1 is used in a surgery, the height of the surgical support device 1 is adjusted by the height adjustment mechanism of the stand 50. It is possible to change the size depending on the body shape of the patient 200, the surgical method, etc. In addition, when using the surgical support device 1 in a surgery by fixing the clamper 8 to the fixing rail 100a of the operating table 100 with the clamper 8 attached to the base body 6, the mounting position of the clamper 8 with respect to the base body 6 may be changed. By adjusting the height of the surgical support device 1, it is possible to change the height of the surgical support device 1 depending on the body shape of the patient 200, the method of surgery, etc.
100 手術台
1 手術支援装置
3 ホルダー
4 固定ベース
6 ベース本体
8 クランパー
9 第1の連結アーム
10 第2の連結アーム
11 第3の連結アーム
20 ロック部材
20a ロック用係合部
25 被ロック部材 100 Operating table 1Surgery support device 3 Holder 4 Fixed base 6 Base main body 8 Clamper 9 First connecting arm 10 Second connecting arm 11 Third connecting arm 20 Locking member 20a Lock engaging portion 25 Locked member
1 手術支援装置
3 ホルダー
4 固定ベース
6 ベース本体
8 クランパー
9 第1の連結アーム
10 第2の連結アーム
11 第3の連結アーム
20 ロック部材
20a ロック用係合部
25 被ロック部材 100 Operating table 1
Claims (4)
- 複数の連結アームと前記連結アームに支持されたホルダーと前記連結アームが連結された固定ベースとを備え、
前記固定ベースは内部に所定の各部が配置されたベース本体と少なくとも一部がベース本体から突出され手術台に固定可能なクランパーとを有し、
前記クランパーの前記ベース本体に対する上下方向における位置が変更可能にされた
手術支援装置。 comprising a plurality of connecting arms, a holder supported by the connecting arms, and a fixed base connected to the connecting arms,
The fixed base has a base body in which predetermined parts are arranged, and a clamper that at least partially protrudes from the base body and can be fixed to the operating table,
A surgical support device, wherein the position of the clamper in the vertical direction with respect to the base body can be changed. - 前記クランパーが前記ベース本体に着脱可能にされた
請求項1に記載の手術支援装置。 The surgical support device according to claim 1, wherein the clamper is detachable from the base body. - 前記クランパーに二つの被ロック部材が設けられ、
前記ベース本体に前記被ロック部材がそれぞれ係合され前記クランパーを前記ベース本体にロックする二つのロック部材が設けられた
請求項2に記載の手術支援装置。 The clamper is provided with two locked members,
The surgical support device according to claim 2, further comprising two locking members that are respectively engaged with the locked members and lock the clamper to the base main body. - 前記ロック部材が筒状に形成され、
前記被ロック部材が軸状に形成され、
前記被ロック部材が前記ロック部材に所定の位置まで挿通されることにより前記クランパーが前記ベース本体にロックされる
請求項3に記載の手術支援装置。 The locking member is formed in a cylindrical shape,
The locked member is formed into a shaft shape,
The surgical support device according to claim 3, wherein the clamper is locked to the base main body by inserting the locked member into the locking member to a predetermined position.
Priority Applications (3)
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PCT/JP2022/014134 WO2023181296A1 (en) | 2022-03-24 | 2022-03-24 | Surgery assistance device |
JP2023521121A JP7360761B1 (en) | 2022-03-24 | 2022-03-24 | surgical support equipment |
CN202280059157.4A CN117881359A (en) | 2022-03-24 | 2022-03-24 | Surgical auxiliary device |
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WO2006002174A2 (en) * | 2004-06-21 | 2006-01-05 | Gmp/Surgical Solutions, Inc. | Apparatus for positioning a medical instrument relative to a patient |
GB0502824D0 (en) * | 2005-02-11 | 2005-03-16 | Univ Bradford | Support arrangement |
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CN103948433B (en) * | 2014-05-06 | 2016-03-02 | 迈柯唯医疗设备(苏州)有限公司 | The fast interface structure of a kind of medical hoist tower adnexa and casing |
CN108371557A (en) * | 2018-03-13 | 2018-08-07 | 无锡市人民医院 | A kind of surgical instruments with the rotatable shaft with multiple latched positions |
DE202020107233U1 (en) * | 2020-12-14 | 2021-01-14 | Olaf Storz | Medical table connection |
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2022
- 2022-03-24 CN CN202280059157.4A patent/CN117881359A/en active Pending
- 2022-03-24 WO PCT/JP2022/014134 patent/WO2023181296A1/en active Application Filing
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JPH08224243A (en) * | 1995-02-22 | 1996-09-03 | Olympus Optical Co Ltd | Medical manipulator |
US5571072A (en) * | 1995-04-28 | 1996-11-05 | Kronner; Richard F. | Dual-axis endoscope holder |
JP2001522688A (en) * | 1997-11-14 | 2001-11-20 | メドシス エス.アー. | Operating devices for surgical instruments |
JP2005524440A (en) * | 2002-05-02 | 2005-08-18 | ジーエムピー サージカル ソリューションズ インコーポレイテッド | Device for positioning a medical device relative to a patient |
JP2015062734A (en) * | 2005-09-30 | 2015-04-09 | インテュイティブ サージカル インコーポレイテッド | Surgical accessory clamp and system |
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JP2022016327A (en) * | 2020-07-09 | 2022-01-21 | ソニーグループ株式会社 | Medical arm device |
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CN117881359A (en) | 2024-04-12 |
JPWO2023181296A1 (en) | 2023-09-28 |
JP7360761B1 (en) | 2023-10-13 |
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